Provider Demographics
NPI:1730377383
Name:WEST, MONIQUE E (MSW,BA,LCSW)
Entity type:Individual
Prefix:
First Name:MONIQUE
Middle Name:E
Last Name:WEST
Suffix:
Gender:F
Credentials:MSW,BA,LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 PLAINS RD UNIT 1C
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06461-2573
Mailing Address - Country:US
Mailing Address - Phone:203-693-1050
Mailing Address - Fax:
Practice Address - Street 1:57 PLAINS RD UNIT 1C
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06461-2573
Practice Address - Country:US
Practice Address - Phone:203-693-1050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-09
Last Update Date:2019-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0820841041C0700X
CT0087111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004040655OtherHP-MEDICAID
CT140008711CT02OtherANTHEM BCBS OF CT -AWAKEN THE POWER THERAPY, LLC
CT472092928OtherTHREE RIVERS AWAKEN THE POWER THERAPY, LLC
CT4990903OtherCIGNA BEHAVIORAL HEALTH -AWAKEN THE POWER THERAPY
CTPENDINGOtherOPTUM BEHAVIORAL HEALTH- UHC AWAKEN THE POWER THERAPY, LLC
CTPENDINGOtherOPTUM BEHAVIORAL HEALTH- OXFORD/FREEDOM AWAKEN THE POWER THERAPY, LLC
CTPENDINGOtherOPTUM BEHAVIORAL HEALTH-UNITED HEALTHCARE AWAKEN THE POWER THERAPY
CT472092928OtherFEI BEHAVIORAL HEALTH AWAKEN THE POWER THERAPY, LLC
CT0060808OtherBEACON HEALTH- VALUE OPTIONS AWAKEN THE POWER THERAPY, LLC
CT12755484OtherCAQH
CT472092928OtherHEALTHY CT- AWAKEN THE POWER THERAPY, LLC
CTPENDINGOtherOPTUM BEHAVIORAL HEALTH CONNECTICARE- AWAKEN THE POWER THERAPY, LLC
CT472092928OtherMULTI-PLAN -AWAKEN THE POWER THERAPY, LLC